Myocardial blood flow assessment with myocardial perfusion scan in patients with coronary artery chronic total occlusion
DOI:
https://doi.org/10.12775/JEHS.2020.10.06.030Keywords
heart, scintigraphy, perfusion, CTOAbstract
Introduction and purpose: Coronary artery disease (CAD) is a leading cardiological problem in modern society. A special form of CAD is the Chronic Total Occlusion (CTO), which affects about 20% of visible coronary artery lesions. The aim of the study is to present the role of myocardial perfusion scintigraphy performed on patients with CTO, and scintigraphic findings in these patients.
Material and method: It was a retrospective study. We analized studies in patients with CTO reported in medical history. We included studies performed between 2016 and 2019. 119 cases were found with the majority of men (M = 95, W = 24). The patients’ mean age was 65 years (M = 65, W = 66). In order to assess ischemia in these patients, the stress test was applied by means of physical exercise (cycloerometer) or pharmacological test. If patient's clinical condition did not allow a stress test, only a rest test was performed.
Results: In the analyzed group the most common occluded vessel was the right coronary artery (59%). In this case, mean ischaemia was found to cover 18% of the myocardium. The second most frequent obstructed vessel was the circumflex (16%) with ischaemia of 15%. The next artery was left anterior descending artery with ischaemia of 30% and other vessel - 7%. 9 patients had more than one vessel closed.
Conclusions: Myocardial perfusion imaging helps to choose optimal treatment in patients with CTO.
References
Stone GW, Kandzari DE, Mehran R, Colombo A, Schwartz RS, Bailey S, Moussa I, Teirstein PS, Dangas G, Baim DS, Selmon M, Strauss BH, Tamai H, Suzuki T, Mitsudo K, Katoh O, Cox DA, Hoye A, Mintz GS, Grube E, Cannon LA, Reifart NJ, Reisman M, Abizaid A, Moses JW, Leon MB, Serruys PW. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I. [Circulation]. 2005; 112 (15): 2364–2372.
Stone GW, Reifart NJ, Moussa I, Hoye A, Cox DA, Colombo A, Baim DS, Teirstein PS, Strauss BH, Selmon M, Mintz GS, Katoh O, Mitsudo K, Suzuki T, Tamai H, Grube E, Cannon LA, Kandzari DE, Reisman M, Schwartz RS, Bailey S, Dangas G, Mehran R, Abizaid A, Moses JW, Leon MB, Serruys PW. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part II. [Circulation], 2005; 112 (16): 2530–2537.
Schumacher SP, Stuijfzand WJ, Opolski MP, van Rossum AC, Nap A, Knaapen, P. Percutaneous coronary intervention of chronic total occlusions: When and how to treat. [Cardiovascular revascularization medicine: including molecular interventions] 2018. DOI: 10.1016/j.carrev.2018.07.025.
Celik T; Ozturk C; Balta S; Iyisoy A. The best treatment option in the management of patients with chronic total occlusion of a single coronary artery: Debate continues. [International journal of cardiology], 2016. 214, s. 79–80. DOI: 10.1016/j.ijcard.2016.03.145.
Kobylecka M. Miejsce badań izotopowych we współczesnej diagnostyce kardiologicznej. [Choroby Serca i Naczyń], 2015; 12 (5), s. 318–323, [Cited: 03.03.2020]. https://journals.viamedica.pl/choroby_serca_i_naczyn/article/download/43803/30101.
Klocke FJ, Baird MG, Lorell BH et al. American College of Cardiology, American Heart Association Task Force on Practice Guidelines, American Society of for Nuclear Cardiology. ACC/AHA/ASNC guideli-nes for the clinical use of cardiac radionuclide imaging: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. [Circulation], 2003; 108: 1404–1418.
Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis. [American heart journal], 2010; 160 (1), s. 179–187. DOI: 10.1016/j.ahj.2010.04.015.
Parol G, Kobylecka M, Bakoń L. Nieinwazyjna diagnostyka choroby niedokrwiennej serca- którą opcje diagnostyczną wybrać? [Diagnostyka Kardiologiczna, Folia Cardiologica ], 2014; Via Medica. 9 (2): 197–204. ISSN 2353–7752.
Yang JH, Kim BS, Jang WJ, Ahn J, Park TK, Song YB et al. Optimal Medical Therapy vs. Percutaneous Coronary Intervention for Patients With Coronary Chronic Total Occlusion - A Propensity-Matched Analysis. [Circulation journal : official journal of the Japanese Circulation Society], 2016; 80 (1), s. 211–217.
de Labriolle A, Bonello L, Roy P. Comparison of safety, efficacy, and outcome of successful versus unsuccess-ful percutaneous coronary intervention in ‘‘true’’ chronic total occlusions. [Am J Cardiol], 2008; 102: 1175–1181.
Gu, L, Zhong, L, Chen K, Wu J, Huang RC. Long-term clinical outcomes of optimal medical therapy vs. successful percutaneous coronary intervention for patients with coronary chronic total occlusions, [Hellenic journal of cardiology : HJC = Hellenikekardiologikeepitheorese], 2018; 59 (5), 281–287.
Teramoto T, Tsuchikane E, Matsuo H, et al. Initial Success Rate of Percutaneous Coronary Intervention for Chronic Total Occlusion in a Native Coronary Artery Is Decreased in Patients Who Underwent Previous Coronary Artery Bypass Graft Surgery. [JACC Cardiovasc Interv], 2014; 7(1): 39-46.
Mączyński M. Wpływ rekanalizacji przewlekle niedrożnej tętnicy wieńcowej na rokowanie pacjentów z chorobą niedokrwienną serca, [Rozprawa doktorska. I Klinika Kardiologii Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu], 2014; Poznań , 37.
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 368
Number of citations: 0
